Individual
NANCY JEAN WASILEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
191 5TH STREET WEST, KETCHUM, ID 83340
(208) 726-5027
(208) 726-8948
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
N21188
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N21188
NURSING LICENSE
ID
Enumeration date
07/07/2006
Last updated
09/19/2012
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